добавлю, что низкая глюкоза при плохом самочувствии и улучшение состояния после в/в введения глюкозы может быть проявлением кетотической гипогликемии, так как поймать низкую глюкозу в крови крайне сложно у детей, то рекомендуют кетоны в крови или моче:
prevalence of clinically significant ketosis (defined as beta-hydroxybutyrate 2.5 mmol/L or more) to be approximately 1800 per 100,000 ED presentations, with more than 170 per 100,000 also being hypoglycemic. Affected patients were 3 months to 9 years of age. 55% of the presentations were boys, and 56% were under the 50th centile for weight.
Conclusions: ...A simple capillary test for ketones should be considered in unwell children younger than 10 years who present with vomiting or lethargy, as this may identify the need for specific therapy to resolve ketosis.
A blood glucose measurement less than 70 mg/dL at the time of symptoms proves the diagnosis of hypoglycemia. Blood and urine tests will show the presence of ketones and sometimes signs of dehydration during the hypoglycemia. Other blood tests are usually normal. Symptoms will go away if the child is able to eat or drink something containing carbohydrates (sugar) or receives fluids containing glucose given into a vein.
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